| NPI | 1154720555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: FL MH15433) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL MCAP100498) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2020-02-06 |